Cancer Genetics and Epigenetics, 2025, Vol.13, No.6, 275-286 http://medscipublisher.com/index.php/cge 276 application suggestions and subsequent research directions, etc. It is hoped that it can provide useful references for medical staff, policymakers and researchers, so as to better improve the care level and health status of such patients. 2 The etiology and Mechanism of Lymphedema in the Ipsilateral Upper Limb 2.1 Lymphatic system damage caused by surgery and radiotherapy In the treatment of breast cancer, surgery, especially axillary lymph node dissection (ALND), is one of the main causes of lymphatic system damage. This type of surgery can disrupt the normal lymphatic return path of the arm, significantly increasing the risk of lymphedema on the same side of the arm. Many studies have shown that patients who have undergone ALND surgery have a much higher risk of lymphedema compared to those who have had sentinel lymph node biopsy (SLNB). Among them, the incidence of lymphedema after ALND is approximately 16% to 30% or more, while the incidence after SLNB is only 5% to 11%. The larger the range of lymph nodes resected by surgery, especially in patients who have undergone three axillary lymph node dissections, the higher the risk of lymphedema (Xu et al., 2025). At the same time, if more branches of the axillary veins can be retained during the operation or new hemostatic and anti-blockage instruments are used, the occurrence of postoperative lymphedema can be reduced and the condition can be prevented from worsening. This indicates that choosing the right surgical method is very important for reducing lymphatic system injury (Ikeda et al., 2025; Zong et al., 2025). Radiotherapy can also increase the risk of lymphatic system damage, especially when the radiotherapy range includes local lymph nodes (RLNR), which may lead to lymphatic vessel fibrosis and reduce their ability to expel lymph fluid. Clinically, it is believed that ALND surgery combined with RLNR radiotherapy is the combination with the highest risk of lymphedema. After 5 years of treatment, the cumulative incidence of lymphedema exceeds 30%. Radiotherapy not only affects the function of lymphatic vessel contraction and lymph fluid storage, but also forces the body to grow new alternative lymphatic drainage channels. However, these new channels are often inefficient and cannot fully replace the traffic diversion function of normal channels. In addition, the scope of radiotherapy and the irradiation method also affect the risk level. The larger the irradiation area and the more likely it is to cause lymphedema when using traditional isolated radiotherapy methods. 2.2 Individual risk factors In addition to the treatment methods, some of the patient's own conditions can also have a significant impact on the occurrence of lymphedema. For a long time, a high BMI (Body Mass Index) associated with obesity has been regarded as an important risk factor for this problem. The probability of lymphedema in obese patients is 1.5 to 2 times that of patients with normal weight (Yao et al., 2025). In addition, elderly patients, those in the advanced stage of cancer, or those who already have other diseases such as diabetes are at a higher risk of developing lymphedema. Postoperative infections, especially cellulitis, are not only one of the causes of lymphedema but also a common problem after surgery. Previous studies have shown that the more severe and prolonged the upper limb lymphedema is, the greater the possibility of cellulitis will occur, and the problem of lymphatic circulation after infection will also be more prominent (Xu et al., 2025). Postoperative inactivity and failure to follow the doctor's requirements for preventive measures can also increase the risk of lymphedema. Conversely, adhering to regular exercise and timely treatment after infection can both help reduce this risk. Furthermore, patients with poor educational level and economic conditions are more prone to lymphedema, which may be because they do not easily receive adequate preventive and rehabilitation assistance (Yao et al., 2025). 2.3 Pathophysiological basis of lymphatic drainage obstruction The core pathogenesis of breast cancer-related lymphedema is the obstruction of lymphatic circulation, which leads to the accumulation of excessive high-protein fluid in the interstitial Spaces of the affected arm. After surgical resection or injury of lymph nodes and lymphatic vessels, the ability of the lymphatic system to transport lymph fluid will decline, resulting in an imbalance in the production and excretion of lymph fluid (Zheng and Hu,
RkJQdWJsaXNoZXIy MjQ4ODYzNA==